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My Living Will or Health Care Instructions My Document of Anatomical Gift The Designation of My Conservator Of The Person For My Future Incapacity As my physician, you may rely on these health care instructions and decisions made by my health care representative or conservator of my person, if I am unable to make a decision for myself. I choose not to appoint a health care representative, please go to the next page. (Initial here) APPOINTMENT OF HEALTH CARE REPRESENTATIVE I appoint.

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